1. The nurse is caring for a 3-year old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction? A.... Blood pressure trend is downward and pulse is rapid and irregular. B.Right foot is cool to the touch and appears pale and blanched. C. Pulse distal to the femoral artery is weaker on the left foot than right foot. D. The pressure dressing at right femoral area is moist and oozing blood. Correct Answer: B. Right foot is cool to the touch and appears pale and blanched Following a motor vehicle collision, a 3-year old girl has a spica cast applied. Which toyis best for the nurse for this 3 year old child? A. Duck that squeaks. B. Fashion doll and clothes C. Set of cloth and hand puppets D. Hand held video game Correct Answer: C. Set of cloth and hand puppets An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Whichaction should the nurse implement first? A. Administer morphine sulphate. B. Start IV fluids. C.Place the infant in a knee-chest position D. Provide 100% oxygen by face mask Correct Answer: C. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respirations. Thenurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? A. Metabolic alkalosis B. Respiratory acidosis C. Respiratory alkalosis D. Metabolic acidosis Correct Answer: D. 7 years old is admitted to the hospital with persistent vomiting, and a nasogastrictube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? A. Gastric output of 100 mL in the last 8 hours B. Shift intake of 640 mL IV fluids plus 30 mL PO ice chips C. Serum potassium of 3.0 mg/dL. D. Serum pH of 7.45 Correct Answer: C. Serum Potassium of 3.0 (normal is 3.5 to 5.5) The nurse is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? A. Creamed Corn B. Pancakes C. Rye Cakes D. Cooked Oatmeal Correct Answer: A. During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing? A. Separation anxiety . B. Associative play. [Show More]
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